Picato gel contains the active ingredient ingenol mebutate, which is a compound purified from the Euphorbia peplus plant. It is used to treat a skin condition called actinic keratosis.

What is it used for?

How does it work?

Picato gel contains the active ingredient ingenol mebutate, which is a compound purified from the Euphorbia peplus plant. It is used to treat a skin condition called actinic keratosis.

Actinic keratoses are rough areas of skin caused by sun damage over many years, eg from sunbathing or using sunbeds, or working outdoors. They occur in fair-skinned people, whose skin is particularly sensitive to the damaging effect of UV rays.

ADVERTISEMENT - CONTINUE READING BELOW

The skin lesions are usually harmless, however about two percent will turn into a skin cancer (squamous cell carcinoma). Some small actinic keratoses may disappear without treatment. However, the chance of an actinic keratosis turning into a skin cancer falls if the actinic keratosis is treated early.

It is not fully understood how ingenol mebutate works in treating actinic keratosis. However, it is thought that it stimulates the immune system to kill the abnormal or damaged skin cells. It also promotes an inflammatory response in the skin similar to that seen if the skin is wounded. The skin then heals itself with normal healthy skin cells.

MOST POPULAR

Ingenol acts locally in the skin and is not absorbed into the bloodstream. There are two strengths of gel available; the 150 micrograms/gram gel is for treating lesions on the face and scalp and the 500 micrograms/gram gel is for treating lesions on the trunk, arms or legs.The gel is applied once daily for two consecutive days for the trunk or limbs, and once daily for three consecutive days for the face or scalp.

You should expect that the gel will cause redness, swelling, blistering, peeling, erosion and scabbing of the skin in the treated areas. The skin reaction will usually start within one day of starting treatment and may get worse for the first week, but the skin will then typically heal within two weeks when treating areas on the face or scalp, and within four weeks when treating the trunk or limbs.

The full effect of the treatment can be evaluated approximately eight weeks after treatment.

How do I use it?

This gel is for external use on the affected area of skin only, under specialist medical supervision.

It is important to follow the instructions given by your doctor, as well as those printed in the information leaflet supplied with the gel.

Picato gel should be applied once a day. It should not be applied immediately after taking a shower or less than two hours before bedtime.

For the treatment of the face and scalp Picato gel 150mcg/g is used; this is applied once a day for three days in a row. For the treatment of the trunk and extremities, eg hands and feet, Picato gel 500mcg/g is used; this is applied once a day for two days in a row.

A new tube of gel should be used for each application. Each tube contains enough gel to cover an area of skin measuring 25cm2 (5cm x 5cm). Each tube is for single use only and should be disposed of after use, preferably by returning it to a pharmacy.

Squeeze the contents of one tube onto a fingertip and gently rub the gel into the area to be treated. Leave the gel to dry for 15 minutes.

Wash your hands with soap and water immediately after applying the gel, unless the hands are the area being treated. In this case, just wash the fingertip used to apply the gel.

Avoid touching or washing the treated area for at least six hours after applying the gel. Also don’t let other people or pets touch the treated area during this time. After six hours you can wash the area with mild soap and water if needed.

Don’t cover the area you have treated with airtight bandages or dressings.

Where do I keep it?

Picato gel should be stored in a fridge before use (2°C to 8°C).

Each tube of gel is for one single application and should be disposed of after use, preferably by returning it to your pharmacy.

Warning!

Do not apply the gel to open wounds or damaged areas of skin, such as areas with infections or dermatitis (eczema).

Avoid contact of this medicine with the eyes and the inside of your mouth and nose (mucous membranes). The gel should not be applied near the eyes, to the inside of your nostrils or ears, or to your lips. Rinse with large amounts of water and get medical advice straight away if you accidentally get the gel in your eyes, nose, mouth or ears.

You should avoid exposure to direct sunlight and sunbeds while using this medicine. Sunlight should be avoided as much as possible by people with actinic keratoses, since the skin lesions are caused and made worse by UV light.

You should expect skin reactions in the area you have treated with this gel. This may involve redness, swelling, blistering, peeling and scabbing of the skin before it subsequently heals – see above. However, if the reaction keeps getting worse after the first week, the skin starts producing pus or you think your skin has become infected, you should consult your doctor.

Not to be used in

Children and adolescents under 18 years of age.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

ADVERTISEMENT - CONTINUE READING BELOW

The manufacturer states that this medicine should not be used in pregnancy. Seek medical advice from your doctor.

It is unlikely that this medicine will pass into breast milk after application to the skin because it is not absorbed into the bloodstream. The medicine can be used by breastfeeding mothers. However, you should make sure that the nursing infant doesn’t come into contact with the area of skin you have treated for six hours after you have applied Picato gel. Get further advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Very common side effects on the area being treated (affect more than 1 in 10 people)

Blistering - formation or vesicles or pustules.

Outer layers of your skin may wear away (erosion).

Swelling.

Peeling of skin.

Scab formation.

Redness due to widening of the small blood vessels (erythema).

Pain (if face and scalp being treated).

Common (affect between 1 in 10 and 1 in 100 people)

Skin irritation or itching at the application site.

Pain at the application site (if trunk and extremities are being treated).

Infection of the skin at the application site (if face and scalp are being treated).

Swelling around the eye and eyelid (if face and scalp are being treated).

Headache (if face and scalp are being treated).

Uncommon side effects (affect between 1 in 100 and 1 in 1000 people)

Sensation of pins and needles at site of application.

Ulceration of skin at application site.

Warmth of skin at application site (if trunk and extremities are being treated).

Eye pain (if face or scalp are being treated).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

If you think you have experienced a side effect from this medicine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it’s necessary they'll report it for you.

How can this medicine affect other medicines?

It is important to tell your pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to make sure that the combination is safe.

This medicine has not been studied in combination with other medicines. It is not absorbed through the skin into the bloodstream, so any effect on other medicines is likely to be insignificant.

You shouldn’t apply other creams, ointments, gels or lotions to the same area of skin that you are treating with Picato, unless directed to by your doctor.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain ingenol mebutate as the active ingredient.

Further reading

For background information about our medicine factsheets, including the references used to produce them, click here.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.